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      Determinants of intergenerational sexual relationships and HIV risk among South African women outpatients in Gauteng.

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          Abstract

          Age-discrepant sexual relationships may place women at risk for HIV infection in South Africa. Results are based on medical records and case-control interview data of 889 sexually experienced women outpatients aged 15-29 in a Gauteng township. Women with partners at least ten years older (intergenerational) show an elevated chance of having an early sexual debut, concurrent and transactional partners, and intimate partner violence. Hardship during childhood including parental loss, food insecurity and abuse are related to age asymmetric relationships. HIV is two times more likely (aOR=1.96) with an intergenerational partner. Transactional sex increases the odds of HIV independently (aOR=1.76) as does intimate partner violence (aOR=1.6). To the extent that transactional and intergenerational sex overlap the chance of contracting HIV increases more than two-fold (uOR=4.57). Girls (15-19) with intergenerational partners face the highest chance of HIV (uOR=8.55) compared to other age groups. They are also five times more likely than controls to have lived with a cross-age partner. Our findings indicate there are multiple pathways emanating from childhood leading to women's choice of intergenerational partners, and the link to HIV is strongest among the youngest women.

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          Author and article information

          Journal
          AIDS Care
          AIDS care
          Informa UK Limited
          1360-0451
          0954-0121
          May 2021
          : 33
          : 5
          Affiliations
          [1 ] Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, USA.
          [2 ] Department of Educational Psychology, University of Pretoria School of Education, Pretoria, South Africa.
          [3 ] UNH Institute on Disability, College of Health and Human Services, University of New Hampshire, Durham, NH, USA.
          Article
          10.1080/09540121.2020.1823311
          32964726
          6fbe52a9-48c3-44f4-9c0c-ae2b03acaed7
          History

          ACES and HIV in Africa,African women and HIV,Age-discordant sex,behavioral risk and HIV,intimate partner violence (IPV) and HIV,transactional sex

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